NPI | 1790820074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301014241) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401009350) |
103K00000X Behavior Analyst (Licence: MI 7401000870) | |
Enumeration Date | 2007-02-21 |
Last Update Date | 2020-07-15 |